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APPLICATION - MAJOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> �4u fTWORIZ4T10N SIGNATURES <br /> ONLY THE OWNER OF TPROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> /,the Owner/Agent agree,to defend,Indemnify,and hold harmless the County and Its agents,officers and employees from any claim,action or <br /> proceeding against the Owner/Agent's project. <br /> 1,further, certify under penalty of perjury that Ism(check one): <br /> o Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the property(s)Involved In <br /> this application,or <br /> o Legal agent(attach proof of the owner's consent to the application of the property's Involved In this application and <br /> have been authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name: -f'')'Y' Signature: Date: b 2 <br /> Print Name: Signature: Date: <br /> PTName: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> INJ[VDf)SVAI➢] ([V,1]/6/01 INO( <br /> -5- <br />